As the years tick on and the body ages, it starts to show signs of wear and tear — resulting in a variety of joint aches and pains caused by arthritis. An estimated 54 million adults in the United States are diagnosed with some form of arthritis each year, according to the Centers for Disease Control and Prevention.
“Arthritis is the progressive loss of the protective cartilage layer that insulates the joint surfaces,” explains Dr. Jeffrey Geller, an orthopedic surgeon who specializes in hip and knee replacement at ColumbiaDoctors Tarrytown, which is part of the faculty practice of Columbia University Medical Center, and Director of Orthopedics and Sports Medicine at NewYork-Presbyterian Lawrence Hospital in Bronxville. “The two most common forms include osteoarthritis (OA), and rheumatoid arthritis (RA).” OA is the “wear and tear” type of arthritis that typically starts to manifest after age 60, but not all of the elderly are affected. RA is an autoimmune disorder in which joint cartilage is misidentified as foreign and the body’s immune system attacks it.
As arthritis progresses, its painful effects on the joints include swelling, stiffness, and deformity. Says Dr. Geller, “In the lower extremities, knee arthritis can manifest as a worsening angular deformity (bow legs or knock-knees). In the hip, it can lead to a flexion deformity, where one walks more hunched over with stiffness in the back. All of these can affect a person’s mobility, activity level and quality of life.”
Early treatments for arthritis include anti-inflammatory medications, physical therapy and cortisone injections. If these non-surgical treatments fail to minimize pain and suffering, a patient might be referred to an orthopedic surgeon for consideration of surgery and possible joint replacement.
“The most commonly replaced joints are the knee, shoulder and hip and there have been very high success rates as a result of the surgery,” says Dr. Geller. In the U.S. each year, more than 600,000 knees and 400,000 hips are replaced. Less common are surgical procedures that involve the elbow and the ankle.
Weight is a major determinant of just how risky or successful the surgery will be. The doctor may advise the patient to lose weight before the operation if it is significantly higher than what it should be. Studies show that a patient with a Body Mass Index (BMI) greater than 40 is more likely to experience serious complications both during and after surgery than a patient of normal weight.
Advances in the durability of the materials used in knee and hip surgeries have typically enabled them to last for 20 years before needing replacement. Some even last a patient’s lifetime. Says Dr. Geller, “When it comes to joint health, there have been advances with technology, pain management, and surgical approaches that have made recovery easier than ever.”
NewYork-Presbyterian Lawrence has earned The Joint Commission’s Gold Seal of Approval for its Joint Replacement Program by demonstrating compliance with the Commission’s national standards for healthcare quality and safety in disease-specific care. The certification award recognizes the hospital’s dedication to patient care in accordance with its state-of-the-art standards.
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